{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T07:32:39Z","timestamp":1771054359543,"version":"3.50.1"},"reference-count":23,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T00:00:00Z","timestamp":1747699200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Testicular germ cell tumors (GCTs) are highly curable malignancies, particularly when diagnosed early. However, cardiac metastases are exceedingly rare\u2014occurring in less than 1% of cases\u2014and pose significant diagnostic and therapeutic challenges. Intracardiac involvement is exceptionally uncommon and typically necessitates a multidisciplinary approach for optimal management. Objective: To present a rare case of metastatic testicular GCT with intracardiac extension in a young male, underscoring the diagnostic complexity and therapeutic considerations of this unusual clinical scenario. Case Report: A 23-year-old male presented with diffuse abdominal pain, dyspnea, and a palpable right testicular mass. Imaging revealed a testicular tumor with metastases to the lungs, liver, retroperitoneal lymph nodes, and a large intracardiac mass extending from the inferior vena cava into the right atrium. Histopathology confirmed a mixed-germ cell tumor consisting of 75% seminoma, 20% embryonal carcinoma, and 5% teratoma. The patient underwent radical right orchiectomy followed by chemotherapy with the BEP regimen (bleomycin, etoposide, cisplatin). Cardiac magnetic resonance imaging confirmed the intracardiac mass, which significantly decreased in size after treatment. Serum tumor markers (AFP and \u03b2-hCG) also showed substantial post-treatment declines, corresponding with clinical improvement. Conclusions: This case highlights a rare presentation of metastatic testicular GCT with intracardiac involvement, emphasizing the importance of recognizing atypical metastases. Despite its complexity, the patient responded well to chemotherapy, reinforcing the effectiveness of current treatments. Long-term follow-up and a multidisciplinary approach are essential for monitoring recurrence and complications, contributing to the understanding of rare metastatic patterns and the need for further research.<\/jats:p>","DOI":"10.3390\/jcm14103564","type":"journal-article","created":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T06:10:46Z","timestamp":1747721446000},"page":"3564","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Unusual Presentation of Metastatic Testicular Mixed-Germ Cell Tumor with Intracardiac Extension: A Case Report"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8445-7256","authenticated-orcid":false,"given":"Marlon","family":"Rojas-Cadena","sequence":"first","affiliation":[{"name":"Department of Cardiology, Universidad Cat\u00f3lica del Ecuador, Quito 170525, Ecuador"},{"name":"One Health Research Group, Universidad de las Am\u00e9ricas, Quito 170124, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felipe","family":"Rodr\u00edguez-Arcentales","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Universidad Cat\u00f3lica del Ecuador, Quito 170525, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Williams","family":"Lata","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital de Especialidades Eugenio Espejo, Quito 170702, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karla Mera","family":"Sacoto","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital de Especialidades Eugenio Espejo, Quito 170702, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis","family":"Guerrero","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital de Especialidades Eugenio Espejo, Quito 170702, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2242-5531","authenticated-orcid":false,"given":"Katherin","family":"Narv\u00e1ez Inca","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Universidad Cat\u00f3lica del Ecuador, Quito 170525, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3717-383X","authenticated-orcid":false,"given":"Marlon","family":"Arias-Intriago","sequence":"additional","affiliation":[{"name":"One Health Research Group, Universidad de las Am\u00e9ricas, Quito 170124, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1895-7498","authenticated-orcid":false,"given":"Esteban","family":"Ortiz-Prado","sequence":"additional","affiliation":[{"name":"One Health Research Group, Universidad de las Am\u00e9ricas, Quito 170124, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1178-0546","authenticated-orcid":false,"given":"Juan S.","family":"Izquierdo-Condoy","sequence":"additional","affiliation":[{"name":"One Health Research Group, Universidad de las Am\u00e9ricas, Quito 170124, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/j.annonc.2022.01.002","article-title":"Testicular Seminoma and Non-Seminoma: ESMO-EURACAN Clinical Practice Guideline for Diagnosis, Treatment and Follow-Up","volume":"33","author":"Oldenburg","year":"2022","journal-title":"Ann. 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